The way forward for UK junior doctors

By
Tony Robson
2 March 2016

Following the decision by Jeremy Hunt, the Conservative Party secretary of health, to impose an inferior contract on 55,000 junior doctors in England by August 1, the British Medical Association (BMA) has announced a further series of industrial action. These entail 48-hour national stoppages on March 9, April 6 and April 26, in which only emergency care will be provided.

The enforcement of the contract will remove unsocial payments and reduce the safeguards against junior doctors working excessive hours.

The decision by the BMA to escalate the rolling strike action, following the 24-hour stoppages in mid-January and beginning of February, came after consultation meetings with junior doctors who voiced their determination to defy the government ultimatum.

The junior doctors’ fight can only go forward by rejecting the “no politics” mantra of the BMA and the isolation of the dispute by the trade unions. No effort is being spared by the BMA in order to prevent the dispute from providing a focal point for the suppressed opposition to austerity and the dismantling of the National Health Service.

The BMA announced the new strikes dates while pleading with the government there is still time to avert the planned industrial action. Even now, after several years of talks, which have only prepared the way for the imposition of a regressive contract, the BMA states, “The Government can avert this action by re-entering talks with the BMA and addressing the outstanding issues and concerns junior doctors have, rather than simply ignoring them.”

The BMA warned that if the government presses ahead with a contract “junior doctors have resoundingly rejected we will be left with no option but to take this action. The Government must put patients before politics, get back around the table and find a negotiated solution to this dispute.”

The BMA’s claim that the dispute is non-political is false to the core. This is not a sectional struggle over pay, but a fight against a government-mandated attack on junior doctors that is directed at all NHS employees in order to facilitate further cuts and the privatisation of services.

Public opinion is overwhelmingly on the side of the junior doctors. The general public trusts their ethics and judgement, upon which the lives and wellbeing of millions depend, over a government dedicated to the interests of the wealthy and intent on eliminating all health and social provision.

The BMA is placing its call to return to negotiations on assurances that it will accept a settlement compliant with the longest spending squeeze on the NHS in its history.

As the Kings Fund commented on the government’s spending review last year, “the NHS and social care are now set for a decade-long funding squeeze which will see the largest sustained falls in spending as a share of GDP on both services in modern times.”

Johann Malawana, chair of the BMA junior doctors committee emphasised the “cost neutral” basis of the alternative it submitted in December, in which the retention of unsocial hours payments would come from a reduction in an increase in basic pay.

The BMA’s attempt to come to a trade off with the government over unsocial hours only serves to obscure the real issues. It gives succour to the disinformation by the mass media that the junior doctors’ resistance is not bound up with a broader fight to defend the NHS.

The BMA presents the government’s actions as simply the outcome of incompetence. On this basis, the BMA has taken up a legal appeal on the grounds that the Tories have not conducted an Equality Impact Assessment, as required by law, in compliance with the Equality Act 2010.

The central risk to the junior doctors is the continued isolation of their struggle by the trade unions. The last one-day stoppage by junior doctors in February coincided with the Trades Union Congress (TUC) official week of action against the government’s anti-strike Trade Union Bill. This only served to expose it as a non-event. Even as the government tore up the pay and conditions of a section of NHS employees—the biggest workforce in the country—the TUC with 52 affiliated unions stood idly by.

The trade unions oppose any unification of the fight against the destruction of public health care. There has been no attempt to enjoin the junior doctors with the fight by nurses and midwives against government decision to scrap NHS bursaries in 2017. Unison, with nearly half a million members in the NHS, has not organised any support behind the junior doctors. Instead, it conducts a separate campaign over bursaries restricted to letter-writing to MPs and pleas to government.

In an attempt to cover for the betrayal of the trade unions, an online petition has been initiated by Unite the Resistance. This is endorsed by a handful of national union leaders under the misleading title “Solidarity with the junior doctors.” Its declaration, “This is the time for solidarity and action” is belied by its contents. It does not go beyond token gestures—including email messages of support and visiting junior doctors’ picket lines and a proposal that the BMA approaches the TUC about the organisation of a national demonstration.

The petition is confined to calls to resume the discredited negotiations in which the BMA is attempting to broker a sellout. “We call on Hunt to withdraw the imposition and listen to the BMA.”

Unite the Resistance consists of the pseudo-left Socialist Workers Party (SWP) and a section of the trade union bureaucracy predominantly drawn from the public sector. It was founded following the TUC betrayal of the 2011 public sector strike and based around the National Unions of Teachers (NUT), University College Union (UCU) and Public and Commercial Services union (PCS) led by Mark Serwotka.

The NUT, UCU and PCS were dubbed the “rejectionist” unions because they initially refused to sign up to the government’s terms. However, they played a central role in demobilising all opposition after winding down a few national stoppages, which they failed to co-ordinate.

The Unite the Resistance signatories includes that of Dave Ward, the assistant general secretary of the Communication Workers Union (CWU). The record of the CWU and Ward over cuts and privatisation is one of collaboration with productivity increases and the culling of jobs and calling off a succession of national strikes including the one prior to the Royal Mail selloff in 2013.

After more than five years of endless austerity, the fact that the Cameron government has not yet confronted a resurgent and militant movement of the working class is due to the services rendered by the trade unions.

They have presided over a record low level of industrial action. This is not a reflection of the reluctance of the working class to wage a fight. In June last year, unions in the public and private sector called off three national strikes in steel, rail and probation services.

Neither the growth in social inequality nor the intensification of the class struggle and even the prospect of more draconian anti-strike laws have roused the trade unions. They are pro-capitalist and dedicated to preserving the lifestyle of a bureaucracy which bargains away the past gains made by workers and polices social discontent on behalf of the government and corporations.

A genuine appeal for solidarity with the junior doctors and a mobilisation of the working class against the Cameron government would cut across all of this. This is why a genuine struggle can only be taken forward based on the creation of rank and file organisations, and an international socialist perspective which challenges the monopoly the financial and corporate elite exerts over every aspect of economic and social life.